A Step toward Tuberculosis Elimination in a Low-Incidence Country: Successful Diagnosis and Treatment of Latent Tuberculosis Infection in a Refugee Clinic
Objectives. Approximately 65 percent of tuberculosis (TB) cases in Canada each year occur from reactivation in foreign-born individuals. Refugees are at high risk after immigration. Routine screening of this population for latent TB infection (LTBI) is generally considered infeasible. We evaluated t...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Canadian Respiratory Journal |
| Online Access: | http://dx.doi.org/10.1155/2016/7980869 |
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| author | Elissa Rennert-May Elisabeth Hansen Toktam Zadeh Valerie Krinke Stan Houston Ryan Cooper |
| author_facet | Elissa Rennert-May Elisabeth Hansen Toktam Zadeh Valerie Krinke Stan Houston Ryan Cooper |
| author_sort | Elissa Rennert-May |
| collection | DOAJ |
| description | Objectives. Approximately 65 percent of tuberculosis (TB) cases in Canada each year occur from reactivation in foreign-born individuals. Refugees are at high risk after immigration. Routine screening of this population for latent TB infection (LTBI) is generally considered infeasible. We evaluated the outcome of LTBI screening and treatment amongst refugees. Methods. Government-sponsored refugees in Edmonton are seen at the New Canadians’ Clinic and screened for TB and LTBI. We reviewed records of patients between 2009 and 2011. Completeness of initial assessment, diagnosis of latent infection, and completion of LTBI treatment were evaluated. Treatment for LTBI was offered when patients had a positive Tuberculin Skin Test (TST) and risk factors for progression to TB. An Interferon-Gamma Release Assay (IGRA) was performed on all other TST positives; treatment is only offered if it was positive. Results. 949 refugees were evaluated. 746 TSTs were read, with 265 positive individuals. IGRA testing was performed in 203 TST positive individuals without other TB risk factors; 110 were positive. LTBI treatment was offered to 147 of 151 eligible patients, 141 accepted, and 103 completed a treatment course. Conclusion. We observed high proportions of patient retention, completion of investigations, and treatment. This care model promises to be a component of effective TB prevention in this high-risk population. |
| format | Article |
| id | doaj-art-b4a1d15054454c11bce80cf05c2b3d3a |
| institution | Kabale University |
| issn | 1198-2241 1916-7245 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Respiratory Journal |
| spelling | doaj-art-b4a1d15054454c11bce80cf05c2b3d3a2025-02-03T05:48:00ZengWileyCanadian Respiratory Journal1198-22411916-72452016-01-01201610.1155/2016/79808697980869A Step toward Tuberculosis Elimination in a Low-Incidence Country: Successful Diagnosis and Treatment of Latent Tuberculosis Infection in a Refugee ClinicElissa Rennert-May0Elisabeth Hansen1Toktam Zadeh2Valerie Krinke3Stan Houston4Ryan Cooper5Infectious Diseases, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, T6G 2G3, CanadaEdmonton TB Clinic, Edmonton, AB, T6G 2J3, CanadaEdmonton TB Clinic, Edmonton, AB, T6G 2J3, CanadaNew Canadians Clinic, Edmonton, AB, T5M 3Z7, CanadaInfectious Diseases, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, T6G 2G3, CanadaInfectious Diseases, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, T6G 2G3, CanadaObjectives. Approximately 65 percent of tuberculosis (TB) cases in Canada each year occur from reactivation in foreign-born individuals. Refugees are at high risk after immigration. Routine screening of this population for latent TB infection (LTBI) is generally considered infeasible. We evaluated the outcome of LTBI screening and treatment amongst refugees. Methods. Government-sponsored refugees in Edmonton are seen at the New Canadians’ Clinic and screened for TB and LTBI. We reviewed records of patients between 2009 and 2011. Completeness of initial assessment, diagnosis of latent infection, and completion of LTBI treatment were evaluated. Treatment for LTBI was offered when patients had a positive Tuberculin Skin Test (TST) and risk factors for progression to TB. An Interferon-Gamma Release Assay (IGRA) was performed on all other TST positives; treatment is only offered if it was positive. Results. 949 refugees were evaluated. 746 TSTs were read, with 265 positive individuals. IGRA testing was performed in 203 TST positive individuals without other TB risk factors; 110 were positive. LTBI treatment was offered to 147 of 151 eligible patients, 141 accepted, and 103 completed a treatment course. Conclusion. We observed high proportions of patient retention, completion of investigations, and treatment. This care model promises to be a component of effective TB prevention in this high-risk population.http://dx.doi.org/10.1155/2016/7980869 |
| spellingShingle | Elissa Rennert-May Elisabeth Hansen Toktam Zadeh Valerie Krinke Stan Houston Ryan Cooper A Step toward Tuberculosis Elimination in a Low-Incidence Country: Successful Diagnosis and Treatment of Latent Tuberculosis Infection in a Refugee Clinic Canadian Respiratory Journal |
| title | A Step toward Tuberculosis Elimination in a Low-Incidence Country: Successful Diagnosis and Treatment of Latent Tuberculosis Infection in a Refugee Clinic |
| title_full | A Step toward Tuberculosis Elimination in a Low-Incidence Country: Successful Diagnosis and Treatment of Latent Tuberculosis Infection in a Refugee Clinic |
| title_fullStr | A Step toward Tuberculosis Elimination in a Low-Incidence Country: Successful Diagnosis and Treatment of Latent Tuberculosis Infection in a Refugee Clinic |
| title_full_unstemmed | A Step toward Tuberculosis Elimination in a Low-Incidence Country: Successful Diagnosis and Treatment of Latent Tuberculosis Infection in a Refugee Clinic |
| title_short | A Step toward Tuberculosis Elimination in a Low-Incidence Country: Successful Diagnosis and Treatment of Latent Tuberculosis Infection in a Refugee Clinic |
| title_sort | step toward tuberculosis elimination in a low incidence country successful diagnosis and treatment of latent tuberculosis infection in a refugee clinic |
| url | http://dx.doi.org/10.1155/2016/7980869 |
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